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https://www.readbyqxmd.com/read/28441671/swimming-upstream-creating-a-culture-of-high-value-care
#1
Reshma Gupta, Christopher Moriates
As health system leaders strategize the best ways to encourage the transition toward value-based health care, the underlying culture-defined as a system of shared assumptions, values, beliefs, and norms existing within an environment-continues to shape clinician practice patterns. The current prevailing medical culture contributes to overtesting, overtreatment, and health care waste. Choosing Wisely lists, appropriateness criteria, and guidelines codify best practices, but academic medicine as a whole must recognize that faculty and trainees are all largely still operating within the same cultural climate...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441339/still-searching-a-meta-synthesis-of-a-good-death-from-the-bereaved-family-member-perspective
#2
REVIEW
Kelly E Tenzek, Rachel Depner
The concept of a good death continues to receive attention in end-of-life (EOL) scholarship. We sought to continue this line of inquiry related to a good death by conducting a meta-synthesis of published qualitative research studies that examined a good death from the bereaved family member's perspective. Results of the meta-synthesis included 14 articles with 368 participants. Based on analysis, we present a conceptual model called The Opportunity Model for Presence during the EOL Process. The model is framed in socio-cultural factors, and major themes include EOL process engagement with categories of healthcare participants, communication and practical issues...
April 25, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28440678/involvement-of-primary-care-physicians-in-the-decision-making-and-care-of-patients-with-breast-cancer
#3
Lauren P Wallner, Paul Abrahamse, Jaspreet K Uppal, Christopher R Friese, Ann S Hamilton, Kevin C Ward, Steven J Katz, Sarah T Hawley
Purpose Collaborative care between cancer specialists and primary care providers (PCPs) may improve the delivery of high-quality cancer care. Yet, patient perspectives about how involved the PCPs were in their breast cancer care and treatment decisions remain unknown. Patients and Methods A weighted random sample of women newly diagnosed with breast cancer in 2013 to 2014, as reported to the SEER registries in Los Angeles, California, and Georgia, were sent a survey approximately 6 months after diagnosis (N = 2,279, 71% response rate)...
November 20, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28440601/measurement-of-exhaled-breath-carbon-monoxide-in-clinical-practice-a-study-of-levels-in-central-pennsylvania-community-members
#4
Shari Hrabovsky, Jessica M Yingst, Susan Veldheer, Erin Hammett, Jonathan Foulds
BACKGROUND AND PURPOSE: Exhaled breath carbon monoxide (eBCO) reading is a useful tool for nurse practitioners to evaluate smoking status and other exposures to carbon monoxide (CO) to identify risk for cancer and chronic disease. This study aimed to measure one community's eBCO and identify potential environmental factors that may affect eBCO among nonsmokers. METHODS: Data collected by convenience sampling at community health events included self-reported tobacco use and potential CO exposure...
April 25, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28439755/what-do-key-stakeholders-think-about-hiv-self-testing-in-canada-results-from-a-cross-sectional-survey
#5
N Pant Pai, M Smallwood, D Gulati, N Lapczak, A Musten, C Gaydos, C Johnston, M Steben, T Wong, N Engel, J Kim
Human immunodeficiency virus (HIV) self-testing presents an empowering alternative to facility-based testing for reaching undiagnosed HIV infected individuals, but is not currently available in Canada. We surveyed stakeholders (clinical providers, public health professionals, researchers) engaged in HIV testing initiatives nationwide to identify the concerns, opportunities and challenges to implementing HIV self-testing in Canada. An online cross-sectional survey was disseminated by the Canadian Institutes of Health Research Centre for REACH 2...
April 24, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28439376/-back-to-bedside-residents-and-fellows-perspectives-on-finding-meaning-in-work
#6
Dustin M Hipp, Kristy L Rialon, Kathryn Nevel, Anai N Kothari, Lcdr Dinchen A Jardine
BACKGROUND: Physician burnout is common and associated with significant consequences for physicians and patients. One mechanism to combat burnout is to enhance meaning in work. OBJECTIVE: To provide a trainee perspective on how meaning in work can be enhanced in the clinical learning environment through individual, program, and institutional efforts. METHODS: "Back to Bedside" resulted from an appreciative inquiry exercise by 37 resident and fellow members of the ACGME's Council of Review Committee Residents (CRCR), which was guided by the memoir When Breath Becomes Air by Paul Kalanithi...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28438592/aga-educational-tools-engage-patients-and-improve-clinical-outcomes
#7
EDITORIAL
J Sumner Bell, Hannah Herrington, Aimee Frank
No abstract text is available yet for this article.
April 21, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28438197/anti-malarial-landscape-in-myanmar-results-from-a-nationally-representative-survey-among-community-health-workers-and-the-private-sector-outlets-in-2015-2016
#8
Si Thu Thein, Hnin Su Su Khin, Aung Thi
BACKGROUND: In 2015/2016, an ACTwatch outlet survey was implemented to assess the anti-malarial and malaria testing landscape in Myanmar across four domains (Eastern, Central, Coastal, Western regions). Indicators provide an important benchmark to guide Myanmar's new National Strategic Plan to eliminate malaria by 2030. METHODS: This was a cross-sectional survey, which employed stratified cluster-random sampling across four regions in Myanmar. A census of community health workers (CHWs) and private outlets with potential to distribute malaria testing and/or treatment was conducted...
April 25, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28437546/root-cause-analysis-and-actions-for-the-prevention-of-medical-errors-quality-improvement-and-resident-education
#9
Ryan Charles, Brandon Hood, Joseph M DeRosier, John W Gosbee, James P Bagian, Ying Li, Michelle S Caird, J Sybil Biermann, Mark E Hake
The quality of care delivered by orthopedic surgeons continues to grow in importance. Multiple orthopedic programs, organizations, and committees have been created to measure the quality of surgical care and reduce the incidence of medical adverse events. Structured root cause analysis and actions (RCA2) has become an area of interest. If performed thoroughly, RCA2 has been shown to reduce surgical errors across many subspecialties. The Accreditation Council for Graduate Medical Education has a new mandate for programs to involve residents in quality improvement processes...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28437511/online-information-on-the-treatment-of-burning-mouth-syndrome-quality-and-readability
#10
Shatha Alnafea, Stefano Fedele, Stephen Porter, Richeal Ni Riordain
AIMS: To evaluate the quality and readability of online information about the treatment of burning mouth syndrome (BMS). METHODS: An internet search using the phrase "burning mouth syndrome treatment" was carried out on the Google search engine (www.google.co.uk) on 8 June 2015, and the first 100 websites listed were examined. Data collection included DISCERN score, the Journal of the American Medical Association (JAMA) benchmarks for website analysis score, the presence of the Health on the Net (HON) Foundation seal, and the Flesch Reading Ease Score (FRES)...
April 2017: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/28437477/outcomes-after-antiretroviral-therapy-during-the-expansion-of-hiv-services-in-haiti
#11
Margaret L McNairy, Patrice Joseph, Michelle Unterbrink, Stanislas Galbaud, Jean-Edouard Mathon, Vanessa Rivera, Deanna Jannat-Khah, Lindsey Reif, Serena P Koenig, Jean Wysler Domercant, Warren Johnson, Daniel W Fitzgerald, Jean W Pape
BACKGROUND: We report patient outcomes after antiretroviral therapy (ART) initiation in a network of HIV facilities in Haiti, including temporal trends and differences across clinics, during the expansion of HIV services in the country. METHODS: We assessed outcomes at 12 months after ART initiation (baseline) using routinely collected data on adults (≥15 years) in 11 HIV facilities from July 2007-December 2013. Outcomes include death (ascertained from medical records), lost to follow-up (LTF) defined as no visit > 365 days from ART initiation, and retention defined as being alive and attending care ≥ 365 days from ART initiation...
2017: PloS One
https://www.readbyqxmd.com/read/28437445/knowledge-and-perception-of-cardiovascular-disease-risk-among-patients-with-rheumatoid-arthritis
#12
Sunjoo Boo, Hyunjin Oh, Erika S Froelicher, Chang-Hee Suh
Patients with rheumatoid arthritis are at increased risk for cardiovascular disease. The prerequisites for reducing the risk of cardiovascular disease are adequate levels of knowledge and being aware of the risk. In this study, the levels of knowledge about cardiovascular disease among patients with rheumatoid arthritis and the perception were evaluated in relation to their actual 10-year risk of cardiovascular disease. This cross-sectional study of 200 patients with rheumatoid arthritis was conducted in a university-affiliated hospital in South Korea...
2017: PloS One
https://www.readbyqxmd.com/read/28437224/structure-process-and-culture-of-intensive-care-units-treating-patients-with-severe-traumatic-brain-injury-survey-of-centers-participating-in-the-american-college-of-surgeons-trauma-quality-improvement-program
#13
Aziz S Alali, Victroia McCredie, Todd G Mainprize, David Gomez, Avery B Nathens
Outcome after severe traumatic brain injury (TBI) differs substantially between hospitals. Explaining this variation begins with understanding the differences in structures and processes of care, particularly at intensive care units (ICUs) where acute TBI care takes place. We invited trauma medical directors (TMDs) from 187 centers participating in the American College of Surgeons Trauma Quality Improvement Program to complete a survey. The survey domains included ICU model, type, availability of specialized units, staff, training programs, standard protocols and order sets, approach to withdrawal of life support, and perceived level of neurosurgeons' engagement in the ICU management of TBI...
February 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28435902/emergency-medical-service-personnel-need-to-improve-knowledge-and-attitude-regarding-prehospital-sepsis-care
#14
Joongmin Park, Sung Yeon Hwang, Tae Gun Shin, Ik Joon Jo, Hee Yoon, Tae Rim Lee, Won Chul Cha, Min Seob Sim
OBJECTIVE: We aimed to evaluate the knowledge and attitudes of emergency medical service (EMS) personnel pertaining to sepsis. We also compared EMS personnel's knowledge of sepsis and their intention to engage in prehospital sepsis management. METHODS: The survey was conducted during education conferences for EMS personnel in December 2013 and January 2015 in Seoul, Korea. The questionnaire composed of 10 questions relevant to sepsis, was distributed on-scene, and was retrieved by investigators after the conference...
March 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28435418/-you-never-know-what-happens-next-young-adult-service-users-experience-with-mental-health-care-and-treatment-through-one-year
#15
Marian Ådnanes, Sissel Steihaug
Fragmented services are a well-known problem in the mental health sector. Mental health service users' experiences of treatment and care can provide knowledge for developing more user-oriented continuity of care. We followed nine young adults with mental health illnesses and complex needs, conducting four interviews with each informant in the course of a year. The aim was to capture their experiences and views about treatment and care, focusing on (dis)continuities and episodes occurring through that year. The users' experiences were affected by shifts and transitions between institutions, units and practitioners while their need was predictability and stability...
July 22, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28435281/first-do-no-harm-institutional-betrayal-and-trust-in-health-care-organizations
#16
Carly Parnitzke Smith
PURPOSE: Patients' trust in health care is increasingly recognized as important to quality care, yet questions remain about what types of health care experiences erode trust. The current study assessed the prevalence and impact of institutional betrayal on patients' trust and engagement in health care. PARTICIPANTS AND METHODS: Participants who had sought health care in the US in October 2013 were recruited from an online marketplace, Amazon's Mechanical Turk. Participants (n = 707; 73% Caucasian; 56...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28434457/system-changes-to-implement-the-joint-commission-tobacco-treatment-tob-performance-measures-for-improving-the-treatment-of-tobacco-use-among-hospitalized-patients
#17
Donna Shelley, Keith S Goldfeld, Hannah Park, Ana Mola, Ryan Sullivan, Jonathan Austrian
BACKGROUND: In 2012 The Joint Commission implemented new Tobacco Treatment (TOB) performance measures for hospitals. A study evaluated the impact of a hospital-based electronic health record (EHR) intervention on adherence to the revised TOB measures. METHODS: The study was conducted in two acute care hospitals in New York City. Data abstracted from the EHR were analyzed retrospectively from 4,871 smokers discharged between December 2012 and March 2015 to evaluate the impact of two interventions: an order set to prompt clinicians to prescribe pharmacotherapy and a nurse-delivered counseling module that automatically populated the nursing care plan for all smokers...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28433962/ten-minute-snapshots-a-team-approach-to-teaching-postgraduates-about-professional-dilemmas
#18
Prabha S Chandra, G Ragesh, Santosh K Chaturvedi
As medical professionals, most of us face professional dilemmas that catch us unawares and are not discussed in medical training. One often learns about these dilemmas on one's own and deals with them with a common sense approach, rather than reflection. The professional dilemmas may concern receiving gifts from patients, handling issues of confidentiality or dealing with personal questions. There is seldom any formal instruction in competencies related to professionalism, especially in India. We adopted a team approach to provide training in these issues to postgraduate trainees in mental health and to engage them in discussion, using team feedback on snapshots of real-life professional situations, which were simulated through role play...
April 12, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28433860/cognitive-intrusion-of-pain-and-catastrophic-thinking-independently-explain-interference-of-pain-in-the-activities-of-daily-living
#19
Mojtaba Talaei-Khoei, Paul T Ogink, Ragini Jha, David Ring, Neal Chen, Ana-Maria Vranceanu
Patients with musculoskeletal illness often report that pain interferes with their ability to engage in activities of daily living. Catastrophic thinking is consistently depicted as an important cognitive factor that hinders adjustment to pain. Current research has also shown that pain negatively impacts an individual's ability to maintain attention on the task at hand. While a measure of the experience of cognitive intrusion of pain (ECIP) has been recently developed to quantify the extent of that impact, little research has explored this issue in everyday settings...
April 14, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28433675/montreal-accord-on-patient-reported-outcomes-use-series-paper-8-patient-reported-outcomes-pro-in-electronic-health-records-can-inform-clinical-and-policy-decisions
#20
S Ahmed, P Ware, W Gardner, J Witter, C O Bingham, D Khairy, S J Bartlett
BACKGROUND: Given that the goal of healthcare systems is to improve and maintain the health of the populations they serve, the indicators of performance must include outcomes that are meaningful to patients. The growth of health technologies provides an unprecedented opportunity to integrate the patient voice into clinical care by linking electronic health records (EHR) to patient-reported outcome (PRO) data collection. However, PRO data must be relevant, meaningful, and actionable for those who will have to invest the time and effort to collect it...
April 19, 2017: Journal of Clinical Epidemiology
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